Harnessing resources from the internet to maximise outcomes from GP consultations (HaRI): a qualitative study

Patients are increasingly expected to manage their health outside of medical consultations. The Internet has become an important source of health-care information and advice. However, research shows that patients’ use of the internet to manage their health is a potential source of strain on the doctor-patient relationship and can disrupt consultations. Our previous research showed that patients may be reluctant to share internet-based health information with their GP as they are concerned this may be perceived as a challenge to their GP’s expertise, however when patients do share the work they have done prior to consulting they expect to have the information, and their efforts at self-management, taken seriously. If GPs fail to do this patients experience reduced trust and in extreme cases breakdown of the doctor-patient relationship. GPs report fears that discussion of information from the internet may derail the consultation, particularly given time constraints, or cause undue anxiety in patients. It is also unclear if, and how, GPs promote or warn against patient use of the internet during consultations or indeed if, and how, they use it themselves in consultations. Previous studies have focused on doctor and patient reports; but we know that what people actually do differs from what they say they do. In this study, we will combine patient and GP reports with videotaped recordings of consultations to establish what actually happens in consultations. We will use all these data to identify effective strategies employed by patients and GPs for raising or responding to health information from the internet. These strategies will then be shared with patients and doctors, to enhance future discussions of material from the internet in consultations.